The Computer-Based Patient Record and Confidentiality

Woodward, Beverly

doi:10.1056/nejm199511233332112

Cited by 59 publications

(26 citation statements)

References 4 publications

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“…Indeed, the computer tool makes possible to heighten possibilities of transmission of the information and the fear persists that personal data could be stolen (21). The history of computer communication systems shows that, despite the precautions taken by program developers, it is difficult to prevent data from being intercepted (22). This is the most challenging question for clinicians : 33% of them cannot express an opinion on the storage of data on the Internet.…”

Section: ← Toward Data Processing Interest and Ethical Issuesmentioning

confidence: 99%

“…There is thus a risk of revealing confidentiality through a cross-checking of data from various computer files and a risk of infringement of individual freedoms to the benefit of certain organizations, in particular administrative, financial or insurance companies (22)(23)(24). On the other hand, IT tools are not always reliable in their handling (complexity of procedures, equipment breakdown or theft, loss or alteration of files, viruses, etc.).…”

Section: ← Toward Data Processing Interest and Ethical Issuesmentioning

confidence: 99%

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Clinicians’ Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App (Preprint)

Lemey¹,

Larsen²,

DeVylder³

et al. 2018

Preprint

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Purpose : Many mental disorders are mostly preceded by a prodromal phase consisting of various attenuated and unspecific symptoms and functional impairment. Electronic Health Records (EHR) are generally used to capture these symptoms during medical consultation. Internet-based and mobile technologies provide the opportunity to monitor symptoms emerging in patients' environment using ecological momentary assessment techniques to support preventative therapeutic decision making.Method :. We assessed the clinical acceptability of a web-based application designed to collect medical data during appointments and provide EMA features. Clinicians at four community psychiatry departments were recruited to participate. They used the application to assess patients and to collect data after viewing a video of a young patient's emerging psychiatric consultation. They were then asked to answer a short anonymous self-administered questionnaire that evaluated their experience, the acceptability of the application, and their habit of using new technologies.Results : Of 24 practitioners solicited, 88% agreed to participate. Most of them were between 25 and 45 years old, and greater age was not associated with poorer acceptability. Most of the practitioners regularly use new technologies, and 90% connect daily to the internet, with 67% connecting three times a day or more. However, only 50% report feeling comfortable with computers. 86% (n=18) of the clinicians would recommend the tool to their colleagues and 67% consider that a daily use would be interesting. Most of the clinicians (76%) found the interface easy to use and useful. However, several clinicians regret the lack of readability (38%) and point out the necessity of improving ergonomy (19%) in particular to facilitate browsing through various subsections. Part of them (24%) are concerned about the storage of medical data and most of them (52%) seem to be uncomfortable with this. Conclusion :In this study we describe the first step of the development of a web application combining an EHR and ecological momentary assessment (EMA) features. This online tool offers the possibility to assess patients and to integrate medical data easily into face to face conditions. The acceptability of this application supports the feasibility of its broader implementation. This app could help to standardize assessment and to build up a strong database. Used in conjunction with robust data mining analytic techniques, such a database would allow exploration of risk factors, patterns of symptom evolution, and identification of distinct risk subgroups.Introduction :

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Section: ← Toward Data Processing Interest and Ethical Issuesmentioning

confidence: 99%

Section: ← Toward Data Processing Interest and Ethical Issuesmentioning

confidence: 99%

Clinicians’ Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App (Preprint)

Lemey¹,

Larsen²,

DeVylder³

et al. 2018

Preprint

View full text Add to dashboard Cite

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“…The US government's Office of Technology Assessment [8] and the UK audit Commission [9] confirmed that healthcare appears to be one of the most attractive targets of attacks: both internal and external abusers attempt to harm the HCCS security (invasion of privacy, hacking, virus, fraud, theft of data or software). The threat against privacy is increased by data aggregation that networked computer systems encourage.…”

Section: Some Identified Risksmentioning

confidence: 99%

Security Model for Health Care Computing and Communication Systems

Kalam¹,

Deswarte²

2003

Security and Privacy in the Age of Uncertainty

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Health Care Computing and Communication Systems (HCCS) are characterized by the complexity of the organizations to take into account and the richness of properties that are required. To address this complexity and richness, we propose a security policy based on roles, groups of objects and context. Indeed, similarly to roles that structure the subjects, we introduce the new concept "group of objects" which structures objects. Our major aim is to facilitate the security policy management, to cope with access right complexity, and to reduce administration errors. Then we develop a security model that covers the diversity of HCCS while achieving a good compromise between the respect of the least privilege principle and the flexibility of the access control. Following a logical approach, we design a formal system that extends the deontic logic, and we express the security policy in our language.

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“…The lack of privacy and confidentiality of patient records is not a new problem. In 1995, 24 people in Maryland were indicted for selling patient information from the state's Medicaid database to four HMOs (Woodard, 1995). As stated by Woodard (1995), the biggest threat to digital patient records is confidentiality.…”

Section: Introductionmentioning

confidence: 99%

Access control using threshold cryptography for ubiquitous computing environments

Al‐Muhtadi

Hill

Alrwais

2011

Journal of King Saud University - Computer and Information Scie

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Ubiquitous computing is revolutionizing the way humans interact with machines and carry out everyday tasks. It extends everyday computing into the physical world, creating computationally smart environments that feature seamless interactions and automation. As a result of the highly distributed nature of ubiquitous computing, it is essential to develop security mechanisms that lend themselves well to the delicate properties of smart ubiquitous computing environments. In this paper, we introduce a context-aware access control mechanism that utilizes threshold cryptography and multilayer encryption to provide a dynamic and truly distributed method for access control. We simulate our access control scheme and show that access control decisions can be made in a timely manner even as we increase key and file sizes. This mechanism is closely coupled with the context-capturing services and security policy service resulting in a fully context-aware and seamless access control mechanism for typical ubiquitous computing scenarios.

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The Computer-Based Patient Record and Confidentiality

Cited by 59 publications

References 4 publications

Clinicians’ Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App (Preprint)

Clinicians’ Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App (Preprint)

Security Model for Health Care Computing and Communication Systems

Access control using threshold cryptography for ubiquitous computing environments

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